Epidemiology of Early-onset Colorectal Cancer in a Safety-net Hospital System in Texas.

Goals: We aimed to characterize risk factors for early versus advanced-stage early-onset colorectal cancer (eoCRC) at our safety-net hospital system.

Background: Colorectal cancer (CRC) is the third leading cause of cancer-related deaths in the United States. Rates of CRC diagnosis in young adults (age below 50) have been rising despite an overall decrease in CRC.

The efficacy and safety of endoscopic submucosal resection in periappendiceal lesions: a systematic review and meta-analysis.

Introduction: Endoscopic submucosal dissection (ESD) is a promising technique for early-stage gastrointestinal neoplasms; however, its use for periappendiceal lesions poses challenges because of anatomical complexities and the potential risk of appendicitis or perforation. As a result, these lesions are often managed surgically. This systematic review and meta-analysis evaluate the safety and efficacy of ESD for periappendiceal lesions.

Vonoprazan and amoxicillin dual therapy versus bismuth-based therapy for eradication: a systematic review and meta-analysis of randomized controlled trials.

Introduction: infection can cause peptic ulcer disease, chronic gastritis, primary gastric lymphoma, and gastric cancer. Treatment with bismuth-based quadruple therapy is typically the first line of treatment but can be challenging due to increased pill burden and adverse effects, leading to nonadherence to therapy. Recent studies have shown that vonoprazan can be used in combination with amoxicillin as a potential treatment option.

Exciton Trapping at Shape-Persistent Molecular Nanotubes.

We report a series of shape-persistent molecular nanotubes with top rim connectivity traversing from an all-meta- (m) to an all-para-phenylene (p) bridged species, including all possible members in between them. Single-crystal X-ray diffraction (SCXRD) and microcrystal electron diffraction (MicroED) data show a large torsional angle for meta-phenylenes relative to para-phenylene rings. Density functional theory (DFT) calculations reproduce the experimental torsional angles and also establish a correlation indicating a gradual increase in strain energy from m (∼31 kcal mol) to p (∼90 kcal mol).

Analysis of Reported Adverse Events Associated with Sphincterotomes: An FDA Manufacturer and User Facility Device Experience (MAUDE) Database Study.

Background: Sphincterotomes are widely used during endoscopic retrograde cholangiopancreatography (ERCP) for duct cannulation and sphincterotomy. ERCP can be associated with various adverse events (AEs); however, those associated with sphincterotome device problems are not well known. We aim to analyze device problems and patient-related AEs associated with sphincterotomes using the Food and Drug Administration's (FDA) Manufacturer and User Facility Device Experience (MAUDE) database.

Primary Sclerosing Cholangitis in the Absence of Inflammatory Bowel Disease Increases the Risk of Colorectal Cancer: A Multi-Centre Propensity Score Matched Analysis.

Introduction: Patients with primary sclerosing cholangitis (PSC) and concomitant inflammatory bowel disease (IBD) are at increased risk of colorectal cancer (CRC). However, the risk of CRC in patients with PSC without IBD remains uncertain. We aimed to evaluate the risk of CRC in patients with PSC without a history of IBD using a large national database.

Hybrid endoscopic submucosal dissection and endoscopic full-thickness resection for R0 resection of T1 colonic adenocarcinoma.

Background And Aims: Malignant colorectal polyps limited to superficial submucosa can undergo endoscopic resection as a curative strategy. Endoscopic full-thickness resection (EFTR) allows en bloc resection of malignant polyps; however, the technique is challenging in lesions with submucosal invasion or those >20 mm in size.

Methods: This original article and accompanying video reviews the technique for hybrid endoscopic submucosal dissection (ESD) and EFTR to allow R0 resection of T1 colonic adenocarcinoma.

Closure of esophageal perforation after stricture dilation with novel through-the-scope clip.

Background And Aims: Perforation during dilation of a refractory stricture can be challenging to manage endoscopically due to the friable nature of the tissue. A dual approximation tissue clip (DAC) is a novel through-the-scope (TTS) closure device designed for endoscopic closure of mucosal defects. There is emerging literature on the use of DACs for closure of resection defects, but there is limited knowledge regarding their efficacy in managing an acute perforation.

Postcolonoscopy Colorectal Cancer in Fecal Immunochemical Test-Positive Individuals: Prevalence, Predictors, and Root Cause Analysis in a Nationwide Cohort.

Introduction: Postcolonoscopy colorectal cancer (PCCRC) represents an important real-world colonoscopy quality indicator. Using a national database, we evaluated predictors of PCCRC in fecal immunochemical test (FIT)-positive individuals, determined the PCCRC 3-year (PCCRC-3y) rate, and performed a root cause analysis (RCA).

Methods: This retrospective cohort study evaluated FIT-positive patients who underwent colonoscopy from January 2015 to July 2022.

Prophylactic Rectal ESD (Endoscopic Submucosal Dissection) Defect Closure and Post-ESD Clinical Outcomes: An International Multi-Center Study (with Video).

Purpose: Prophylactic endoscopic submucosal dissection (ESD) defect closure has been suggested to reduce delayed adverse events (DAE) associated with ESD but the data are limited. We aim to study the effect of prophylactic rectal ESD defect closure on post-ESD outcomes.

Methods: An international multicenter retrospective cohort study was performed between 2016 and 2023 involving patients who underwent rectal ESD without intraprocedural perforations and had follow-up data available for at least 2 weeks post-ESD.

An Audit of Indications for Endoscopic Submucosal Dissection for Colorectal Lesions in North America: A Systematic Review and Meta-Analysis.

Endoscopic mucosal resection (EMR) is a safe and effective treatment for most large colorectal lesions Endoscopic submucosal dissection (ESD) can be performed in cases suspicious for superficial submucosal invas. This decision is often operator dependent and based on optical diagnosis of polyp morphology and surface vascular and pit pattern. Here, we conduct a systematic review and meta-analysis of ESD performed for colorectal lesions in North America to evaluate the proportion of ESD performed for benign colorectal lesions.

Dexmedetomidine as an Adjunctive Sedative in Patients Undergoing Endoscopic Submucosal Dissection: A Systematic Review and Meta-Analysis.

Introduction: Endoscopic submucosal dissection (ESD) is a technique for removing dysplastic lesions in the gastrointestinal tract but carries risks like pain and perforation. Dexmedetomidine, an α2-receptor agonist, offers potential benefits as an adjunct sedative during ESD by providing anxiolysis and analgesia. This systematic review and meta-analysis assesses its efficacy and safety.

Pseudoaneurysms Post-biliary Stenting: A Comprehensive Literature Review.

Purpose: Pseudoaneurysms (PSA) following endoscopic biliary stenting are a rare, potentially life-threatening adverse event. Incidence, diagnostic approach, treatment, and prevention of PSA remain unknown. In this comprehensive literature review, we aimed to evaluate the association of developing PSA following biliary stent placement.

International, Multicenter Analysis of Endoscopic Full-Thickness Resection of Duodenal Neuroendocrine Tumors.

Introduction: Nonexposed endoscopic full-thickness resection (EFTR) using a dedicated full-thickness resection device can be used to perform en bloc resection of subepithelial lesions throughout the gastrointestinal tract. In this article, we aim to evaluate the safety and efficacy of EFTR for the management of duodenal neuroendocrine tumors (dNETs).

Methods: This was an international multicenter retrospective study of device-assisted EFTR for dNET.

Outcomes of interval cholecystectomy after EUS-guided gallbladder drainage: a systematic review and meta-analysis.

Background And Aims: Cholecystectomy (CCY) is considered the criterion standard intervention for acute cholecystitis (AC). However, EUS-guided gallbladder drainage (EUS-GBD) can be performed in patients unfit for surgery. Interval CCY after EUS-GBD is typically not performed because the formation of a cholecystoenteric fistula increases the technical complexity of CCY.

Impact of Artificial Intelligence on Clinical Research.

Artificial intelligence (AI) has potential to significantly impact clinical research when it comes to research preparation and data interpretation. Development of AI tools that can help in performing literature searches, synthesizing and streamlining data collection and analysis, and formatting of study could make the clinical research process more efficient. Several of these tools have been developed and trialed and many more are being rapidly developed.

Percutaneous needle decompression for tension pneumoperitoneum during GI endoscopy: a step-by-step guide.

Background And Aims: GI tract perforations during endoscopy can lead to serious adverse events such as tension pneumoperitoneum. In such cases, intraprocedural percutaneous needle decompression can be a lifesaving technique, in addition to allowing procedure completion. The aim of this study is to review the indications for percutaneous needle decompression and provide a step-by-step procedural guide with case examples.

Short Interval Repeat Colonoscopy After Inadequate Bowel Preparation Is Low Among Veterans.

Background: Adenoma detection rate and interval colon cancer rates are associated with bowel preparation quality. The US Multisociety Task Force recommends repeat colonoscopy for individuals with inadequate bowel preparation (IBP) within 1 year. However, little is known regarding the rate and associated factors of repeat colonoscopy after IBP.